Anderson Orthopaedic Research Institute, Alexandria, Virginia.
J Arthroplasty. 2020 Aug;35(8):2022-2026. doi: 10.1016/j.arth.2020.03.024. Epub 2020 Mar 18.
Total knee arthroplasty (TKA) is associated with increased risk of prolonged narcotic requirement compared to unicompartmental knee arthroplasty (UKA). The purpose of the current study is to compare acute postoperative narcotic consumption between the 2 procedures and quantify narcotic consumption.
From October 2017 to August 2019 patients were surveyed for four weeks to determine the amount and duration of opioids consumed and requirement for continued narcotics. Among 976 opioid naïve patients, 314 (32%) underwent UKA and 662 (68%) underwent TKA. Patients were analyzed according to specific narcotic prescribed. Total morphine equivalent dose (MED), number of pills, duration, refill percentage, and usage percentage for 4 weeks were calculated for each procedure.
MED used in the postoperative period was lower in patients undergoing UKA than TKA (200 ± 195 vs 259 ± 250 MED, P = .002). Total number of pills consumed and duration of use was less in UKA compared to TKA regardless of which opioid was prescribed. A smaller proportion of patients required narcotics for 4 weeks after UKA (32% vs 43%, P < .001), and fewer UKA patients required narcotic refills (14% vs 27%, P < .001). Sixty pills of any 1 type of narcotic was sufficient for 90% of UKA patients and over 75% of TKA patients.
UKA is associated with less narcotic consumption, shorter duration of use, less refills, and lower likelihood of narcotic requirement for 4 weeks. We report narcotic consumption patterns for both procedures to aid surgeons in judicious postoperative prescribing.
This is a level III retrospective cohort study reviewing narcotic use in over 900 consecutive opioid naïve patients undergoing UKA or TKA.
与单髁膝关节置换术（UKA）相比，全膝关节置换术（TKA）会增加对长期麻醉需求的风险。本研究的目的是比较两种手术术后急性阿片类药物的消耗，并量化麻醉药物的消耗。
2017 年 10 月至 2019 年 8 月，对 976 名阿片类药物未使用的患者进行了四周的调查，以确定患者所消耗的阿片类药物的数量和持续时间，以及对持续使用阿片类药物的需求。在这 976 名阿片类药物未使用的患者中，314 名（32%）接受了 UKA，662 名（68%）接受了 TKA。根据特定的麻醉处方对患者进行分析。计算了每个手术的术后总吗啡等效剂量（MED）、药丸数、使用时间、续药率和 4 周内的使用率。
接受 UKA 治疗的患者在术后使用的 MED 低于 TKA（200±195 与 259±250 MED，P=0.002）。无论哪种阿片类药物处方，UKA 患者消耗的药丸总数和使用时间都比 TKA 患者少。UKA 患者在术后 4 周需要使用阿片类药物的比例较低（32%比 43%，P<0.001），需要阿片类药物续药的患者比例也较低（14%比 27%，P<0.001）。90%的 UKA 患者和超过 75%的 TKA 患者需要 60 片任何一种类型的阿片类药物。
UKA 与较低的麻醉消耗、较短的使用时间、较少的续药以及术后 4 周内较低的麻醉需求相关。我们报告了两种手术的麻醉消耗模式，以帮助外科医生合理开具术后处方。
这是一项回顾性队列研究，对 900 多例连续接受 UKA 或 TKA 的阿片类药物未使用患者的麻醉使用情况进行了评估，属于 III 级证据。
